28 days old

Network Contract Manager - US Telecommute - 916008

Columbus, OH 43215 Work Remotely
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  • Job Code
    916008

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

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The Network Contract Manager develops the provider network (physicians and hospitals) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. Network Contract Managers evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties.

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Youll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.

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Primary Responsibilities:

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  • Assess and interpret customer needs and requirements
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  • Identify solutions to non - standard requests and problems
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  • Solve moderately complex problems and / or conduct moderately complex analyses
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  • Work with minimal guidance; seek guidance on only the most complex tasks
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  • Translate concepts into practice
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  • Provide explanations and information to others on difficult issues
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  • Coach, provide feedback, and guide others
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  • Act as a resource for others with less experience
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Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

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Required Qualifications:

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  • Undergraduate degree or equivalent experience
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  • 2+ years of experience in a network management-related role, such as contracting or provider services
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  • 2+ years of experience in fee schedule development using actuarial models
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  • 2+ years of experience utilizing financial models and analysis in negotiating rates with providers
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  • 2+ years of experience in performing network adequacy analysis
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  • In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)
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  • Intermediate level of knowledge of claims processing systems and guidelines
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  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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Preferred Qualifications:

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  • 1+ years of experience working with Medicaid
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  • Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form others
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  • Strong interpersonal skills, establishing rapport and working well with others
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  • Strong customer service skills
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Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 7 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

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Colorado Residents Only: The salary range for Colorado residents is $64,800 to $116,000. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: Network Contract Manager, Network Management, Contract Management, MLTSS, Hospital Contracting, Physician Contracting, Medicaid, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Columbus, OH, Ohio

Posted: 2021-03-26 Expires: 2021-04-25

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Network Contract Manager - US Telecommute - 916008

UnitedHealth Group
Columbus, OH 43215

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